Tuesday, 23 Oct 2018

Hospital Appointments Status

Questions (470)

Seán Fleming

Question:

470. Deputy Sean Fleming asked the Minister for Health when a person (details supplied) will receive a date for a surgery; and if he will make a statement on the matter. [43795/18]

View answer

Written answers

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Cancer Research

Questions (471)

Stephen Donnelly

Question:

471. Deputy Stephen S. Donnelly asked the Minister for Health the amount and type of investment in pancreatic cancer research here; his plans to co-operate with other countries fighting the disease; and if he will make a statement on the matter. [43848/18]

View answer

Written answers

Minister for Health

It is not currently possible to quantify the amount of investment across all areas of pancreatic cancer research, which can span clinical trials, epidemiological studies of causes and outcomes, and laboratory based research. The funding sources for such research include the Health Research Board and Science Foundation Ireland, cancer charities and pharmaceutical company funded clinical trials.

In line with the National Cancer Strategy 2017-2026, a National Cancer Research Group is currently being established. The Group will improve co-ordination and oversight of cancer research nationally and provide a forum for the agreement of research priorities. The Group will also seek to achieve continuity of funding and to ensure that funding allocations are linked to the agreed research priorities.

Hospital Facilities

Questions (472)

Pat the Cope Gallagher

Question:

472. Deputy Pat The Cope Gallagher asked the Minister for Health his plans to reopen the short-stay unit at Letterkenny University Hospital; the timeline for the reopening of the unit; the number of beds planned for same; the timeframe for the recruitment of the new staff required for the short stay unit; if a budget has been ring-fenced for the unit; and if he will make a statement on the matter. [43861/18]

View answer

Written answers

Minister for Health

Arising from the recommendations in the Health Service Capacity Review, my Department engaged with the HSE this year to identify the location and mix of beds across the hospital system which could be frontloaded to address pressures being experienced in our hospital Emergency Departments.

This process culminated in the development by the HSE of a Capacity Plan, which identified over 600 acute beds and 290 residential care beds, to be phased in between 2018 and 2020, including a 20-bed short stay ward in Letterkenny University Hospital.

As a first step towards the implementation of the Capacity Plan, €10 million in funding is being made available in 2019 to prepare the ground for opening additional acute beds for winter 2019/2020. My Department is currently engaging with the HSE to finalise the details of this investment.

Hospital Facilities

Questions (473)

Niall Collins

Question:

473. Deputy Niall Collins asked the Minister for Health his plans to upgrade Croom Orthopaedic Hospital; and if he will make a statement on the matter. [43867/18]

View answer

Written answers

Minister for Health

As this is a service issue, I have asked the HSE to reply to you directly.

Hospital Waiting Lists

Questions (474)

Bernard Durkan

Question:

474. Deputy Bernard J. Durkan asked the Minister for Health the extent to which a chain of command exists within the health service in respect of each discipline with particular reference to the need to ensure the abolition of waiting lists and-or identification of their case; and if he will make a statement on the matter. [43924/18]

View answer

Written answers

Minister for Health

Reducing waiting time for patients for hospital operations and procedures is a key priority for the Government.

This year has seen ongoing improvements with the number of patients waiting for inpatient and day case procedures (IPDC), now at 72,700 from the peak of 86,100 in July 2017, amounting to a 16% reduction. The number of patients waiting over 9 months has reduced from over 28,000 to under 19,200 in the same period equating to a 32% reduction.

In Budget 2019 the Government has further increased investment in this area, with funding to the National Treatment Purchase Fund (NTPF) to increase from €55m in 2018 to €75m in 2019.

In 2019, the NTPF plans to deliver 25,000 Inpatient Day Case treatments, building on the 20,000 procedures delivered in 2018. In addition, 5,000 Gastro Intestinal Scopes will be carried out, bringing to 9,000 the additional scope activity provided by the NTPF since the start of 2018. Furthermore, 40,000 Outpatient appointments will be arranged as part of 2019 activity. It is expected that as a result of validation a further 34,000 patients will be removed from the waiting lists by the NTPF Central Validation Unit.

My Department is working closely with the NTPF and the HSE to finalise a coherent Waiting List Action Plan for 2019 before the end of this year. The priority of my Department is to maintain a seamless continuation of the considerable progress made this year into next year.

More broadly, the Sláintecare Implementation Strategy, which was published on 8th August 2018, provides the framework within which a system-wide reform programme will be advanced. It is a further step in the detailed implementation process for this programme and sets out four overarching goals and ten high-level strategic actions which will be the key focus for the first three years of the reform programme. At its core, the strategy focuses on establishing the building blocks for a significant shift in the way in which health services are delivered in Ireland.

The recent Budget provided an increase of €1.05 billion in Health funding. This brings the health budget for 2019 to €17 billion. This is the highest level of Health investment in the history of the State. This will allow the health service to meet additional demands due to the demographic pressure of a growing and ageing population. The additional funding provided as part of Budget 2019 will directly support a range of additional services including initiatives proposed in the Sláintecare Report and committed to in the Sláintecare Implementation Strategy.

Cancer Screening Programmes

Questions (475)

Bernard Durkan

Question:

475. Deputy Bernard J. Durkan asked the Minister for Health his plans for the elimination of the backlog and waiting lists for women awaiting the results of cervical smear tests; and if he will make a statement on the matter. [43925/18]

View answer

Written answers

Minister for Health

On 30 April last, I announced that any woman who had had a CervicalCheck smear test, and whose GP considered that they should have a further test, could access such a test without charge. This decision was taken in the context of the need to provide reassurance to women in light of the media attention surrounding CervicalCheck. I am advised by the HSE that current CervicalCheck laboratory activity remains significantly above normal levels. This is a result both of out-of-cycle smears, and also increased uptake in the screening programme generally. This has impacted turnaround times for results of smear tests.

The HSE advises that every effort is being made to ensure that tests are processed as quickly as possible, having regard to the high standards required for testing. This is a priority concern for my Department and the HSE.

Heads of Agreement have now been signed with the contracted labs to extend their contracts pending the introduction of HPV testing as the primary screening test, and these include arrangements to address the backlog in testing.

It is important to emphasise that smear tests are a screening test and not a diagnostic one, and if any women is concerned or is experiencing any symptoms, she should consult with her GP.

Hospital Waiting Lists

Questions (476)

Bernard Durkan

Question:

476. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it has been found possible to identify the precise issues within the health services that continue to cause delays and long waiting lists; and if he will make a statement on the matter. [43926/18]

View answer

Written answers

Minister for Health

I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families. Improving waiting times for hospital procedures is a key commitment in the Programme for Government. Investing in additional capacity, including beds and theatre space; the progression of recruitment and retention of staff; the delivery of the NDP project, including dedicated elective only hospitals and the ambitious reform agenda in the Sláintecare Report will improve waiting times and access for patients.

In the recent Budget the Government further increased investment to tackle hospital waiting lists, with funding to the NTPF to increase from €55m in 2018 to €75m in 2019.

The latest Waiting list figures for September, published by the NTPF show that the number of patients on the inpatient and daycase waiting list now stands at 72,700. This represents a 16% reduction in the overall number of patients waiting for an inpatient or day case procedure from a peak of 86,100 in July 2017. The number of patients waiting over 9 months has reduced from over 28,100 to under 19,200 in the same period equating to a 32% reduction.

While the total numbers on the Outpatient waiting list continues to grow, a targeted approach by the HSE and Hospital Groups in late 2017 and into 2018 has impacted on the level of growth. The period January-September 2017 saw growth of almost 57,800 while growth has reduced to 14,800 in the same period in 2018. In addition, the NTPF is working closely with Hospital Groups inviting proposals to facilitate the trialling of funded interventions, and at the end of September had approved almost 12,700 outpatient appointments.

In addition, the recent Budget provided an increase of €1.05 billion in Health funding. This brings the health budget for 2019 to €17 billion. This is the highest level of Health investment in the history of the State and will allow the health service to meet additional demands due to the demographic pressure of a growing and ageing population. The additional funding provided as part of Budget 2019 will directly support a range of additional services including initiatives proposed in the Sláintecare Report and committed to in the Sláintecare Implementation Strategy. Sláintecare will focus on meeting the demand for health care that our population currently has, and which will continue to grow in future years.

Medical Card Eligibility

Questions (477)

Bernard Durkan

Question:

477. Deputy Bernard J. Durkan asked the Minister for Health the reason it remains consistently difficult to obtain discretionary full medical cards for cancer patients; and if he will make a statement on the matter. [43927/18]

View answer

Written answers

Minister for Health

The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

Nevertheless, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment including medical evidence of cost and necessary expenses.

With regard to persons suffering from cancer and other serious medical conditions the HSE also has a system in place for the provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent or on-going medical care that they cannot afford and also for persons in palliative care who are terminally ill. These medical cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are followed up with a full application within a number of weeks.

I would also like to note that since 1 July 2015, the HSE adopted the position that all children under 18 years of age with a diagnosis of cancer are awarded a medical card. This card is valid for a period of 5 years.

Emergency Departments Waiting Times

Questions (478)

Bernard Durkan

Question:

478. Deputy Bernard J. Durkan asked the Minister for Health the degree to which adequate provision is being made at various hospitals nationally to ensure that patients waiting on trolleys are reduced to the minimum; and if he will make a statement on the matter. [43928/18]

View answer

Written answers

Minister for Health

I wish to acknowledge the distress overcrowded EDs cause to patients, their families and frontline staff working in very challenging working conditions in hospitals throughout the country.

This Government remains committed to tackling overcrowding in EDs and improving access to health services. Preparations and planning for Winter 2018-19 are well advanced at hospital and local level. The Department of Health is working with the HSE to ensure that these local and regional plans are consolidated and supported through policies and plans at national level to ensure the most effective response to the winter challenges to unscheduled care provision.

As part of Budget 2019, an additional €10m in funding is being provided in 2018 to anticipate and manage critical demand pressures for health service, most particularly in respect of emergency pressures in the initial and latter parts of the year. This funding will focus on initiatives to enable the hospital system to de-escalate before Christmas. Supporting patients in the over 75 age group will be a priority, with measures to respond to surge in demand with home support packages, transitional care beds, GP out-of-hours and aids and appliances to support the journey home of patients following a hospital stay.

I have asked that there be a significant uplift in the provision of social care measures to promote hospital discharging in the first quarter of 2019 in response to the expected surge in demand after the Christmas period.

Improving access to health services is a key priority in 2019. In the first quarter of 2019, in the region of 80 additional beds will be brought on stream, including an additional 30-bed ward in Our Lady of Lourdes Drogheda, a 40-bed modular ward block in South Tipperary General Hospital, and four high dependency beds in the Mater and Cork University Hospital respectively. In addition, the new ED planned for Our Lady of Lourdes Drogheda is due to open early in 2019.

Minister for Health

The Government is aware of workforce issues facing general practice, including the influence of demographic factors, and has implemented a number of measures to improve recruitment and retention in general practice.

GPs play a crucial role in the provision of primary care services. The number of GPs on the specialist register continues to increase – up from 2,270 in 2010 to 3,668 in 2018 and the number of GPs with a GMS contract has also risen from 2,098 in 2008 to 2,494 as at 1 July 2018.

GP training places have been increased from 120 in 2009 to 193 in 2018 and the Government's objective is to continue to achieve annual increases in the number of training places available while ensuring that all of the places are filled.

Entry provisions to the GMS scheme have been changed to accommodate more flexible GMS contracts and the retirement age has been extended to 72. An enhanced support package for rural practices has been introduced with improved qualifying criteria and an increased financial allowance of €20,000 per annum.

The Government remains committed to the continued development of GP capacity to ensure that patients across the country continue to have access to GP services and that general practice remains an attractive career option.

Home Care Packages

Questions (484)

Bernard Durkan

Question:

484. Deputy Bernard J. Durkan asked the Minister for Health the extent to which home care packages have been developed in the course of the past three years to date; the way in which the costs compare with hospital or nursing home costs; and if he will make a statement on the matter. [43934/18]

View answer

Written answers

Minister of State at the Department of Health

The Home Support Service is a core service for older people and is highly valued by service users, their families and by the HSE. It provides supports which assist older people to live independently in their own homes for longer and enables large numbers of people to return home following acute hospital admission who otherwise would remain in hospital or would be admitted to long stay residential care. This allows care to be provided in the community, which is a key principle of the vision of and implementation plan for Sláintecare.

There has been sustained significant investment in these services over the past number of years which has seen the growth in the home support budget from a base of €306m in 2014 to €418m in 2018.

The HSE has begun streamlining home care services by introducing a single funded home support service in 2018. This brings together the funding for home help and standard home care packages which now operates as a single home support service from 2018 onwards. The HSE’s 2018 National Service Plan provides for a target of some:

- 17.094m home support hours to be provided to 50,500 people, which compares with last year’s 16.34m hours delivered to 50,000 people (home help and home hours combined). This is an increase on 2017 provision of 754,000 hours to 500 more people;

- 235 intensive home support packages will provide 360,000 home support hours for people with complex needs.

Minister for Health

I have asked the HSE to respond to you directly on this matter.